Gun control measures may be more effective at reducing firearms suicides in the U.S. than increasing behavioral health capacity, a new study suggests.
The study, published in Health Affairs, found that a 10% increase in behavioral health workers per state was associated with a modest 1.2% reduction in the gun suicide rate from 2005 to 2015.
The Ohio State University researchers estimated that eliminating all mental health professional shortage areas through workforce hiring could reduce the national gun suicide rate — which rose 17.1% during that period — by less than 5%.
The authors noted that other studies show having guns at home is a strong risk factor for suicide, especially among adolescents, for whom suicide is the second-leading cause of death.
Expanding access to behavioral healthcare is worthwhile, but they maintained that improved firearm safety or limited access could also deter suicides and firearms deaths with "a larger return on public health investment."
Suicides make up about 60% of the 36,000 gun violence deaths in the U.S. each year. Older white men are the highest risk group.
The study was prompted by intense public debate over whether the solution to the U.S. gun violence epidemic is stricter gun laws or greater access to mental health services, the OSU researchers said. Little research has been done on the relationship between behavioral health services and gun deaths.
Other experts agreed that policies and programs to reduce firearms access, such as so-called red-flag laws, can help prevent suicides. But they cautioned that the epidemic of firearm suicides and other gun deaths can't be solved simply through gun control policies, and that expanded access to behavioral healthcare is important.
"Safe storage has absolutely been shown effective in reducing adolescent firearms suicides, but adults are a different population," said Dr. Megan Ranney, a gun violence researcher at Brown University. "But jumping to the conclusion that (gun control) policies alone are what's needed is overly simplistic."
One possible reason that boosting the behavioral healthcare workforce hasn't reduced gun suicides more is that older white men, who are at greatest risk, are the least likely group to seek help, said Dr. Marian Betz, a gun violence researcher at the University of Colorado. For that group, safer storage and reducing gun access might work well.
"People who are going through tough times might need mental health or substance abuse help," she said. "But we also have to make sure they don't have access to firearms to keep them safe in that period of risk. Focusing on one or the other might not be enough."
A separate study in the same issue of Health Affairs found that the public increasingly sees gun violence and other forms of violent behavior through the lens of mental illness, despite strong evidence that mentally ill people are far more likely to harm themselves or be victims of violence.
The researchers found an increased public perception that mentally ill people pose a risk of violence to others and growing support for coercive treatment. More than 60% of people surveyed as part of NORC's National Stigma Study saw people with schizophrenia as dangerous to others, with 44% to 59% supporting coerced treatment. Those percentages are significantly higher than found in previous NORC surveys in 1996 and 2006.
"These findings reflect political discourse, not scientific data, and could lead to policies that would be ineffective and misdirect the search for the underlying roots of violence while unnecessarily increasing stigma toward people with mental illness," the authors wrote.
The University of Colorado's Betz, whose research focuses on suicide prevention, strongly agreed.
"It's important to fight against the perception that a mental health problem means you are at much higher risk of hurting others, which is not what the data tells us," she said. "The focus on mental health is holding us back. We need attention to both mental health and gun control."
